title: Catatonia in DSM-5.
abstract: Although catatonia has historically been associated with schizophrenia and is listed as a subtype of the disorder, it can occur in patients with a primary mood disorder and in association with neurological diseases and other general medical conditions. Consequently, catatonia secondary to a general medical condition was included as a new condition and catatonia was added as an episode specifier of major mood disorders in DSM-IV. Different sets of criteria are utilized to diagnose catatonia in schizophrenia and primary mood disorders versus neurological/medical conditions in DSM-IV, however, and catatonia is a codable subtype of schizophrenia but a specifier for major mood disorders without coding. In part because of this discrepant treatment across the DSM-IV manual, catatonia is frequently not recognized by clinicians. Additionally, catatonia is known to occur in several conditions other than schizophrenia, major mood disorders, or secondary to a general medical condition. Four changes are therefore made in the treatment of catatonia in DSM-5. A single set of criteria will be utilized to diagnose catatonia across the diagnostic manual and catatonia will be a specifier for both schizophrenia and major mood disorders. Additionally, catatonia will also be a specifier for other psychotic disorders, including schizoaffective disorder, schizophreniform disorder, brief psychotic disorder, and substance-induced psychotic disorder. A new residual category of catatonia not otherwise specified will be added to allow for the rapid diagnosis and specific treatment of catatonia in severely ill patients for whom the underlying diagnosis is not immediately available. These changes should improve the consistent recognition of catatonia across the range of psychiatric disorders and facilitate its specific treatment.
authors.affiliation: Department of Psychiatry, University of Florida Medical School, Gainesville, FL, USA.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Tandon
authors.forename: Stephan
authors.initials: S
authors.lastname: Heckers
authors.forename: Juan
authors.initials: J
authors.lastname: Bustillo
authors.forename: Deanna M
authors.initials: DM
authors.lastname: Barch
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Gaebel
authors.forename: Raquel E
authors.initials: RE
authors.lastname: Gur
authors.forename: Dolores
authors.initials: D
authors.lastname: Malaspina
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Owen
authors.forename: Susan
authors.initials: S
authors.lastname: Schultz
authors.forename: Ming
authors.initials: M
authors.lastname: Tsuang
authors.forename: Jim
authors.initials: J
authors.lastname: van Os
authors.forename: William
authors.initials: W
authors.lastname: Carpenter
mesh_terms: D002389:Catatonia / Q000145:classification* / Q000175:diagnosis*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans
keywords: Catatonia; Classification; DSM; DSM-5; Diagnosis; Mood disorder; Nosology; Schizophrenia